ANAL ITCHING

ANAL ITCHING

Strategies to Stop the Scratching

K ristie is dressed in her Sunday best for a visit to Aunt Gert. You're so proud of how sweet she looks . . . until you notice what part of her anatomy she's scratching. Again.

One of the most frequent causes of anal itching in preschoolers is pinworms. (See page 276 for more information on pinworms.) Other common causes include chafing, hemorrhoids and a yeast infection. The irritating itch may also follow a bout of diarrhea, or it may simply be the result of poor hygiene, says Paul M. Fleiss, M.D., a pediatrician, lecturer at the University of California, Los Angeles, School of Public Health and assistant clinical professor of pediatrics at the University of Southern California School of Medicine.

Some of these causes may require a doctor's intervention. But others are more easily remedied. Once a doctor has ruled out anything serious, you can try some of these tips at home to help your child find relief.

MEDICAL ALERT

When to See the Doctor
You should take your child to a doctor for a diagnosis if the anal itching is accompanied by weight loss, diminished appetite or constant stomach upset, says Paul M. Fleiss, M.D., a pediatrician, lecturer at the University of California, Los Angeles, School of Public Health and assistant clinical professor of pediatrics at the University of Southern California School of Medicine. These could be signs of a more serious problem. You'll also need to check with a physician if there's a raw, oozing rash or if there are other symptoms of infection such as fever or nausea.
Pinworms, yeast infections and hemorrhoids are other causes of anal itching that may require a doctor's attention, according to Dr. Fleiss. The doctor can prescribe medication that will reduce the itching and speed your child's recovery from these conditions.

Keep the area dry.
''It's important to keep your child's bottom dry,'' says Dr. Fleiss. Moisture can cause irritation as well as create an ideal environment for yeast infection, he says.

Have your child change his underwear several times a day. ''For a persistent itch, change your child's underpants frequently (three or four times a day), and don't let your child wear them to bed,'' he says.

Take a powder. ''A cornstarch powder may be helpful for keeping the anal area dry,'' says Dr. Fleiss. When you apply it to the child, be sure to shake the powder into your hand and then spread it on his bottom. Don't shake it all over, because it could be irritating if inhaled.

Always come clean. ''Itching could be due to the child's not cleaning himself well,'' says Dr. Fleiss. So teach your child to wipe himself properly. ''Dry toilet paper cannot get the anal area completely clean,'' he points out. But some children can easily learn to clean themselves with moistened toilet paper.

''Show your child how to wet the toilet paper and use it after each bowel movement,'' Dr. Fleiss suggests. ''It's a good idea to bathe after a bowel movement. Or have a supply of moistened wipes near the toilet for him to use,'' he says. Afterward, he should use dry toilet paper to finish wiping.

Serve fiber-rich foods. Hemorrhoids are rarely the cause of anal itching in children. But if your child has been diagnosed with a case of these bulging veins, it's time for some diet changes.

''Be sure your child eats more high-fiber foods such as vegetables, fruits and whole grains and cuts down on low-fiber items such as cake, candy, cookies and potato chips,'' says Dr. Fleiss. ''A low-fiber diet can cause constipation. When a constipated child strains to have a bowel movement, that can result in hemorrhoids or aggravate those already there.'' When increasing dietary fiber, it's also important to see that your child drinks more water and eats more fruits and vegetables, he says.

Sitz 'em down. In a bathtub, dissolve three to four tablespoons of baking soda in a couple of inches of warm water and have your child sit in it for 15 minutes or so, suggests Howard Jeffrey Reinstein, M.D., a pediatrician in Encino, California, and clinical assistant professor of pediatrics at the University of Southern California School of Medicine, Children's Hospital of Los Angeles. ''Sitz baths are very soothing to itchy bottoms, regardless of the cause,'' he says.

Add oatmeal where he sitz. For some extra relief, try putting one packet of Aveeno Bath Treatment containing colloidal oatmeal, a finely powdered form of oatmeal, into your child's bathwater. ''It's especially soothing,'' says Dr. Reinstein.

Smooth on something soothing. Though it's mainly intended for insect bites, Itch-X Gel is an over-the-counter anti-itching medication that can be useful for anal itching, too, says Dr. Reinstein. It's for external use only. He also suggests trying petroleum jelly ( Vaseline) or a soothing over-the-counter ointment such as Desitin to coat and protect the itchy area.

Look out for lingering laundry soap. ''Traces of laundry soap in your child's clothing can sometimes cause an itch,'' says Susan Aronson, M.D., a pediatrician at The Children's Hospital in Philadelphia and clinical professor of pediatrics at the University of Pennsylvania. ''To get the last traces of soap out, put your child's clothes through an extra rinse,'' she says.

Get the softness out. Some kids are also sensitive to fabric softeners, adds Dr. Aronson. If you've been using them in your laundry, stop for a while and see if that reduces the itching.

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Warning: The reader of this article should exercise all precautionary measures while following instructions on the home remedies from this article. Avoid using any of these products if you are allergic to it. The responsibility lies with the reader and not with the site or the writer.
The service is provided as general information only, and should not be treated as a substitute for the medical advice of your own doctor.